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Big Toe Joint Pain Explained: What’s Causing It and How to Find Relief

Posted on July 23, 2021June 30, 2025 by admin

Big toe joint pain can be one of the most frustrating foot complaints. It is simply because the great toe joint has a very important function for normal walking. Arguably, it is probably one of the most important joints in the foot and ankle. A lot of your body weight rolls over it as your body propels forward. Therefore, any pain or limited range of motion in this joint makes it difficult to engage in activities. You may compensate so much that you will have pain elsewhere such as the heel or Achilles’ tendon. You may also have a lot of pain first thing in the morning when you get up. It may be difficult to wear shoes that have any type of heel because there is more pain when the toe is forced to move up. You may also have a painful enlargement on the top of the joint that causes pain when shoes rub it.

Big Toe Joint Basics

Much like the kneecap, the patella, the big toe joint has two sesamoid bones. These bones sit underneath the big toe joint. They are oval-shaped bony structures with muscles and tendons attached to them. They help increase strength so that we have more power to push off the toe. Similar to how the knee cap functions for the knee joint. The big toe joint should have a lot of range of motion, approximately sixty degrees upward off the walking surface. When the joint becomes damaged, and range of motion is reduced significantly pain results along with an altered gait.

Causes for Toe Joint Pain

Foot type(biomechanics) – For many, it is biomechanics. People can have a foot type that allows them to walk a certain way, and because of their improper foot mechanics, the great toe joint starts to jam. This can take place over many years so by the time you reach middle age the range of motion in the joint could be dramatically reduced. Along with this, there can be a spur on the top of the great toe that will make the knuckle look exceptionally large. The name commonly used to describe this condition is Hallux rigidus or Hallux limitus. Both describe that the Hallux (big toe) has limited motion. What is going on inside is that joint cartilage is starting to wear down because of this jamming effect. Therefore, you are getting the degenerative joint disease (osteoarthritis) along with this. Understand that just because you are getting osteoarthritis in the toe does not mean you’re going to get it in other joints because this common condition is based upon foot mechanics.
Sesamoiditis – You may also find that you have pain not throughout the joint, but rather just on the bottom of the big toe. This could very easily be caused by irritation to the sesamoid bones. This can happen from damage to the sesamoid bones. This could be from excessive weight-bearing beneath the big toe for long periods or from trauma. Or with an injury, the sesamoid bones could be fractured.
Trauma – Trauma can also cause pain in the great toe joint. It could be trauma from the toe getting jammed, and therefore cartilage inside the joint is damaged and this could result in long-term pain that eventually leads to more long-term arthritis because the cartilage has now been damaged. As I mentioned before, you can also get sesamoid pain from trauma to the great toe joint.
Arthritis – Patients can have rheumatoid arthritis or psoriatic arthritis that’s caused by autoimmune disease. This can also affect a great toe joint. This is usually also going to affect other joints in the hands and the feet.
Gout – The big toe is commonly affected by gout. The toe will become very warm and red. Gout can be very painful. It is commonly treated by certain types of nonsteroidal anti-inflammatory or medication to lower uric acid in the blood which when elevated puts you at risk for gout.

Treatments for Toe Joint Pain

Treatments can vary from simply using medication such as anti-inflammatory medication, different shoe gear, possibly orthotic devices in the shoe gear, or surgery. First, let us talk about shoe gear. If you find that your toe doesn’t want to move very much, you may need to consider a shoe that doesn’t flex as much. Stiff-soled shoes are sometimes helpful. If you’re a lady, you must avoid heels. If you find that you have a knuckle on the top of the toe that’s sticking up, you also may need to avoid a shoe that rubs against this knuckle area, as this could also cause pain. If you have pain underneath the big toe, as we spoke about before with sesamoiditis pain, you may find that you need to wear a shoe that has quite a bit of support or some cushioning underneath the great toe, so that you’re not impacting the sesamoid bones as much.

Medication

Whether you have just generalized wear and tear on the great toe joint, which we call hallux limitus or hallux rigidus, or if you have a more complicated issue with an autoimmune disease like rheumatoid arthritis, oftentimes anti-inflammatory drugs or special drugs for an autoimmune disease may be prescribed.

It’s my opinion that long-term use of anti-inflammatory drugs, such as ibuprofen are not good for the health of the joint and should be used sparingly. However, if you are suffering from an autoimmune disease such as rheumatoid arthritis following your doctor’s recommended medication is important advice.

Orthotic Devices

Orthotics are especially useful to help with the reduction of the progression of hallux limitus, and also with the pain, especially in the early phases of hallux limits. You will also find that orthotics are excellent for the treatment of sesamoid pain underneath the big toe joint. If your shoes are not helping enough you need to consider orthotic devices.

Regenerative Therapeutics

Delaying or avoiding surgery!! Currently, as we’ve been using regenerative therapeutics for many years for problems such as plantar fasciitis and Achilles tendon pain it’s also been useful to eliminate joint pain not only in the great toe and ankle but other joints of the foot. We originally started with PRP( platelet enriched plasma) and more currently use umbilical cord or placenta cell products. This technique has been extremely useful to delay or avoid surgical treatments.

Surgery

Surgery for hallux limitus could be as involved as a fusion of the great toe joint or the use of an artificial great toe joint. But in most cases, the surgery that is used is simply to remove the spurring on the top of the great toe that is causing the jamming; and in some cases, repositioning the joint will help it move more freely. These can be quite successful.

In conclusion, if you have great toe joint pain, don’t put up with it for long. It is a very difficult problem to live with – especially if you’re always having to favor your great toe joint or find it difficult to wear certain shoes. It’s best to treat it early because the measures that we take at Anderson Podiatry Center are proactive and we will do our best to avoid surgery for your toe joint pain.

Diabetic Foot Care: Important Steps to Follow.

Posted on July 7, 2021 by admin

Do you have questions about diabetic foot care? Read this to know more!

Diabetes can be profoundly serious for your feet. In this blog, I will explain what you need to know about diabetic foot care. But before we get started on a list of things to keep in mind, it’s important to remember three basic principles about your feet. Understanding the following will give you better clarity regarding your diabetic feet and what’s important to consider.

Three ways diabetes affects your feet.

The nervous system – If you have diabetes there is a 50-70 percent chance you will have neuropathy. Diabetes can cause nerve damage especially in the feet and lower extremity. This will result in the symptoms of burning tingling and numbness in the feet. Because of numbness problems such corns and calluses may not be felt. At first the idea of numbness in the feet may not seem that bad because it might prevent you from feeling pain but that’s where the problem lies. This prevents the warning signs of pain that can be associated with an ingrown nail, a cut or blister. Quite common and serious issues occur with callouses on the bottom of the foot. With no pain the callous may eventually break down the skin causing an ulcer. Once the skin has broken open from the ulcer an infection is likely, and this can eventually get into bone. Once this occurs an amputation is more likely,so without the nervous system giving a warning in the form of pain problems such as corns, calluses, blisters and ingrown nails become more serious.
Circulatory system – It’s also known with diabetes that you have a higher propensity to have decreased blood flow to the lower extremity, especially the feet. When this happens, if there is any kind of cut or problem with the foot it may be harder to heal properly. It should also be emphasized that smoking combined with diabetes should be avoided. There is a many fold increase of circulatory complications with people who smoke. If a toe is injured with a cut and develops an ulceration, a dark area of the skin in this area could be an indication of gangrene and should be evaluated immediately.
Foot Deformities – Any type of foot problems such as a bunion or a hammer toe can create any irritation where the bony prominence will rub against shoe gear. This too can cause a problem because this can lead to a breakdown in the skin in the form of a callous or a corn that can eventually cause a foot ulcer. Properly fitted shoes are especially important. If the deformity is severe and difficult to accommodate in shoe gear, surgical correction may be considered by the podiatrist after appropriate workup, to ensure adequate blood flow is present for healing. Better to correct earlier then later in some situations as the circulation could become compromised enough later in the life to where surgery would be too risky.

General guidelines to follow

By following these tips, you can do a lot to take better care of your diabetic feet.

Be sure that you bathe your feet daily. Be careful to dry your feet especially between the toes after you are done.
It’s a good idea to inspect your feet every day. You may need to use a mirror to look throughout the foot on the top and on the bottom. Also in between the toes for any types of cracks or cuts that may be there.
Make sure to avoid walking barefoot. This is obviously a problem if you step on a foreign body or a cut.
Make sure that you test water with your hand before putting your foot in warm water such as a hot tub or a bath.
Use appropriate shoe gear and socks.
Make sure that you attributed nails and not dig in on the sides. Try to cut them somewhat straight across as if you don’t this could cause an ingrown nail.
Make sure that you control your diabetes well by controlling your blood sugar levels.
Make sure that you see your podiatrist on a regular basis. Some will recommend coming in every two to four months just for a general foot inspection.
With diabetes your feet may become drier, and this can cause cracking of the skin. So be sure to keep your skin moisturized.
Make sure that you have your foot checked by a professional, especially if you are getting a corn or a callus that could be problematic and painful.
Never treat corn and calluses yourself. Over the counter products that are sold frequently have acids in them that eat away at the corn or callus. This is too risky to use in the diabetic foot.
Wear socks to bed if your feet are cold at night.

Diet Tips

To stop or delay nerve damage avoid carbohydrates and sugars. Make sure to have a diet that includes vegetables, fruits and protein. Also, a diet that includes fat is important as nerves need fat for proper function. Make sure it’s healthy fat such as grass-fed butter. A daily habit I have is to add grass fed butter to my coffee along with cinnamon. This avoids unhealthy additions to the coffee such as sugar or artificial creamers. The fat also satisfies your hunger so that you’re less likely to want to eat. A great book to use as a reference is Sugar Crush written by a colleague of mine Dr. Richard Jacoby.

Following these general guidelines should help you protect your feet from a dangerous situation that could occur when you have diabetes. Educating yourself is key when you want to prevent any serious problems.

Achilles Tendon Heel Pain: How to Avoid it and What are Your Best Treatment Options.

Posted on June 23, 2021June 30, 2025 by admin

Treating the root of the problem for an achilles tendon injury

The Achilles tendon originates from the large calf muscles in the back of the lower leg and attaches to the back of the heel bone. Its function is to push your heel up off the ground and to propel you forward. Pain can occur along the tendon, that band of tissue just below the calf muscle, or where the tendon attaches to the heel bone. The pain can be very disabling, not allowing you to walk or run anymore and or do other activities. It may limit the range of motion in your ankle because of the pain. You may also notice swelling of the tendon associated with your pain. If the back of the heel bone appears enlarged, it may be from the Achilles tendon. So even though a heel spur or boney growth on the back of the heel may be noted it is now thought that in many cases the pain is from the tendon. These problems are referred to as a Haglund’s deformity or a retrocalcaneal spur. This goes against much of conventional medicine as our approach but the high success rate of our treatments for an achilles tendon injury that are directed at treating the tendon and not the bone prove otherwise.

Diagnosis

The diagnosis of achilles tendon injury and heel pain is usually made by the doctor’s clinical exam. However, diagnostic ultrasound or MRI may also be used for a more accurate evaluation.

Causes

Overuse – This is a common cause for injuries sustained to the achilles tendon. If you overdo it without gradually increasing the activity so your body has time to recover this can be a problem.
Types of activities – Some activities may make you more susceptible to achilles injury and heel pain. This would include running up and down hills, or any activity where impact or jumping is involved.
Age – As we get older it is thought that the tendon can become weaker. When this happens the tendon gradually starts breaking down.
Foot type – Improper foot structure and biomechanics may also play a role. An example is a foot that over pronates, flattens, which may cause more pulling on the tendon. A high arch foot may allow the heel bone to rub against the Achilles tendon.
Weight – Excessive weight can put excessive load and stress on the tendon.

Prevention

Shoe gear – Avoid wearing shoes when your active that are broken down. The lack of support may lead to heel pain or Achilles’ tendonitis.
Heel lifts – If your just beginning to experience pain using a heel lift can take some of the stress off the tendon.
Changing activities – Consider backing off activities or changing the activity to one that puts less demand on the tendon.
Stretching – This may also be important both before and especially after activity.
Anti-inflammatories – taking anti-inflammatories short term may also be useful but long-term use should be avoided as they may have a negative effect on your bodies natural healing processes.

Treatments

Treatments that your doctor may recommend can include resting the area and sometimes immobilizing the area in a walking boot. Physical therapy along with heel pain stretches may also be considered. Also, anti-inflammatories may also be suggested. These treatments can work in the early stages but if the problem is more severe or chronic maybe band aid approaches.

The top four treatments we offer that get at the root cause of the problem. It may not be tendonitis!

Regenerative medicine – new terminology Achilles TENDONOSIS
The use of stem cell treatments for over the past decade have proven to be phenomenally successful. The new way of thinking about the Achilles tendon and heel pain is that the problem has more to do with the tendon breaking down and having small, microscopic tears then being inflamed. This is called tendinosis. That is why the use of regenerative medicine make more sense. It’s used to repair damaged tissue rather than treat inflammation which may not be present.
Orthotics – The myth of the tight Achilles tendon
Orthotics are commonly used and have a high success rate, why? We know that with every step you take your heel bone rolls from side to side. This motion is thought to put more pulling on the tendon along its length and where it attaches to the heel bone. A custom made orthotic greatly reduces this motion and often eliminates the problem. This goes against the conventional thought. Yes, the pain can be from a tight Achilles but from our experience its less likely than previously thought.
Shockwave – Shockwave is also a treatment that has been successful. Shockwave is similar lithotripsy where sound waves are used to break up kidney stones. This type of treatment sends powerful sound waves in the Achilles tendon area and traumatizes the tendon, but this stimulates your body to send more cellular components to the area that help repair the tendon. This has also shown quite significant relief for patients with this issue.
Accelerated Laser Pain Therapy – Laser works on a cellular level helping the mitochondria of the tendon tissue repair the tendon. The mitochondria is the area of each cell that creates energy and is responsible for cellular repair.

If the above options fail, surgery may be considered to treat the injury.

Surgery can also be effective but is exceedingly rare as the approach we with orthotics, regenerative medicine, shockwave and laser as options is highly successful at getting you back to full activity.

So if you find yourself dealing with this, understand that you can start out by treating on your own by the suggestions offered in this blog. But the longer this goes on, it’s more important to seek professional attention to ensure that you’re having this treated aggressively. There is a solution for your Achilles tendon heel pain. It’s important that you have consultation with somebody that is proficient providing the treatments we’ve recommended for injuries of this type. If your getting nowhere and feeling frustrated with your present situation please feel free to contact and we’ll help you to evaluate if our approach is appropriate for you.

How Do You Get Rid Of Heel Spur Pain?

Posted on May 19, 2021July 12, 2025 by admin

Your thinking about heel spur pain is all wrong!

Heels spur pain is one of the most common foot problems. It is a type of pain that often occurs when you first step out of bed in the morning. The pain can be excruciating and can find you limping to the bathroom. It can also happen later in the day. And oftentimes, if you have been active one day, say you went out for a run or a hike or a walk, and it was longer than normal, you can expect the same problem in the morning, but this time it’s worse. It can go on for months or years. But what is really happening inside your foot. This blog will open your eyes to some misconceptions about heel spur pain.

Why do I have a heel spur?

Let’s start with the basics. Many of you have heard of plantar fasciitis. The plantar fascia is a strong fibrous band of tissue that runs along the bottom of your foot starting in the ball and attaching to the bottom of the heel. With every step you take as the arch flattens the fascia is being pulled. When you are a teenager or child its very flexible like a rubber band but as you get older it loses its elasticity and starts to pull from where it attaches to the heel. So, let’s discuss the actual heel spur. Many patients will have a heel spur on the bottom of the heel on x-ray. This is a calcium deposit that may occur from the constant pulling of the fascia on the heel in this location. It is a bony protrusion that extends from the heel bone towards the toes. Another theory is that there can be microfractures in the heel from the fascia pulling so hard and the spur in a result of the heel bone attempting to repair. So, the most current understanding is that the actual spur is seldom if ever the true source of your pain. It is the result of the fascia pulling from the bone. What is the evidence to support this?

Three reasons to prove your heel spur does not hurt.

Surgery – approximately ten percent of patients we treat have surgery when conservative measures fail. Surgery is performed endoscopically. The surgeon makes one or two small incisions and then releases a portion of the fascia. Patient may ambulate in a cam walker. This procedure allows the fascia to stretch and has an extremely high success rate. Many patients that have this done have a spur that is left. So, its not the spur.

WE’VE BEEN DOING THIS PROCEDURE FOR 30 YEARS.
Regenerative medicine treatments – We now know that the fascia is not inflamed. Dr. Harvey Lemont (DPM)¹ did a study that involved taking specimens of the fascia when he did surgery. Out of 50 specimens only one showed inflammation, fasciitis. Forty-nine of the specimens show degeneration of the fascia. We call this plantar fasciosis. Starting 10 years ago we changed our approach to treatment and have shifted away from the use of cortisone injections to use of regenerative medicine. Currently we use placenta cells as this helps to repair the tissues that are degenerating.
Diagnostic ultrasound– Every patient we see has a evaluation of their heel ultrasound. This is the same technology used for mothers to see their child during pregnancy. The ultrasound will reveal the abnormal thickness and color that is associated with plantar fascia pain. This allows use the grade or rate the severity on the problem. Also the thickness of the fascia is reduced to more normal size after regenerative treatments.

Causes

The causes of heel pain can be multiple. If is often that that a tight calf and Achilles tendon can cause foot pain include heel spur pain. It may also be from improper foot biomechanics such as a foot that over pronates(flattens). Also, it can be from overuse or just the fact that as we get older its believed the fascia loses its elasticity. Also having tight calf muscles or Achilles tendon is thought to cause foot pain including heel pain.

Treatments

For some stretching or using a night splint you may get some relief. Also, some medical advice will be to use anti-inflammatories or do physical therapy. If you are currently doing any activity that involves running or jumping it may be suggested to take some time off these activities. Cortisone injections may also have some benefits. Using over the counter supports may also help.

We found these four treatments have had greatest success.

1. Orthotics – Many podiatrists will recommend shoe inserts that we call orthotics. We are using a scanning technique that allows use to get a very precise measurement of your foot for these to be made.
2. Regenerative medicine – We’ve been having success the use of stem in the form of placenta cell. We’ve been using regenerative medicine to repair the damaged fascia (plantar Fasciosis) for over ten years.
3. Laser – Laser works by repairing the fascial tissue at a cellular level. Helping the energy producing part of the cell called the mitochondria the function better.
4. Shockwave treatment – has also been phenomenally successful. Shockwave comes from the technology called lithotripsy which is used to break up kidney stones. Powerful sound waves are transmitted into the bottom of your heel and the trauma it creates stimulates your own body to want to repair the damaged tissue(fascia). It is believed that your own bodies growth factors and stem then are stimulated to repair the tissues. Finally, to use of laser can also be considered.

Surgery – Finally, if conservative options fail we’ve had great success with surgical treatment. The procedure done endoscopically so we’re able to visualize the fascia through small incisions. The fascia is released so that it can stretch, and patients are able to bear weight in a camwalker.

As you can see, at Anderson Podiatry Center, we offer both conventional and non-conventional, more progressive concepts when it comes to plantar fasciitis, which we like to call plantar fasciosis. We use evidence-based treatments that have been proven with the latest’s science regarding your heel spur pain. And as you can tell from this blog you need to rethink the idea that it is a spur. Because of the multitude of options we have we have a greater chance of avoiding surgery for our patients.

So, if you’re stumbling around, suffering with plantar fascia pain , or what you might be commonly calling now heel spur pain, please give us a call and we’ll consult you to see which direction we should go with your treatment.

¹Lemont, Harvey. “Https://Pubmed.Ncbi.Nlm.Nih.Gov/12756315/.” National Library of Medicine, June 2003, pubmed.ncbi.nlm.nih.gov/12756315.

What are the best treatments to straighten painful hammertoes?

Posted on April 27, 2021June 30, 2025 by admin

Hammertoes are an affliction that affects millions of Americans. They can be very painful and disabling – not allowing people to be fully active because of the pain. Hammertoes may also be referred to as mallet toes or claw toes depending on their appearance and seldom affect the big toe.

Causes

Hammertoes can be caused by a shoe that is too tight, so make sure the shoe fits properly. This is especially true if one toe is slightly longer than the adjacent toes. This can push or shove on the toe to deform it. Hammer toes can also be caused by nerve problems that result in muscle weakness such as a drop foot condition or Charcot-Marie tooth disease. However, in most cases the cause could be from an imbalance between the flexor tendons and the extensor tendons that pull the toes up towards you. This imbalance causes the toe to flex.

In the affected toe the area of irritation may be on the tip of the toe, which if flexed too much bears weight rather than the fatty pad that it should rest on. This can be very painful and can result in the development of corn. The reason why is because the toe is resting on skin and bone instead of the fatty pad it should be resting on. When this results in corn, a vicious cycle starts. The toe is never straight, you can trim off the corn or callus, but it keeps coming back time after time.

The other area that can be affected with a hammertoe is the knuckle of the toe. When the toe is flexed, it is also sitting higher than the other toes and may rub against your shoe gear. So selecting a shoe with a deeper toe box and avoiding heels should be considered. There are other cases where a toe may be angulated slightly, which happens a lot on the fifth toe. And this sideways angulation, along with the flexion, creates irritation between the neighboring toe and the corn can result between the two toes. So how does one straighten a hammertoe?

Treatments

Treatment options can vary, including wearing wider shoes or shoes with a deeper toe box. Padding can also be used to help alleviate the pressure in these particular areas. Your doctor may recommend arch supports or shoe inserts. For many, however, these treatment options are a constant battle and may never resolve the problem permanently. Therefore, your doctor may recommend surgery to straighten the toe.

For those that require surgery to straighten the toe here are the three options.

Option 1

For more mild hammertoes, it may involve simply making a small incision on the toe to release the tendon that flexes the toe down. And this can be quite rewarding if the deformity is quite mild.

Option 2

Another treatment option would be to remove the knuckle. The bony joint knuckle is removed in many cases, which allows the toe to be straightened more easily and to stay in this corrected position. By removing the toe joint, the toe still can function, but these toes do not need a joint as they do not bear a load such as a knee. This is oftentimes highly successful for patients.

Option 3

The most aggressive treatment for more severe hammertoes would be the type of surgery where a pin is used. And in some cases, the pin may be kept in but in most cases, they are removed. There are also various types of implants that are placed in the toe to make sure that the toe stays straight. In all of these cases the joint is removed for the placement of the implant. Recovery can vary from a few days in a dressing or up to three weeks in a dressing before returning to shoes.

Overall, when the problem becomes severe and you are constantly having to pad the area or trim off the corn or callus, it’s important to consider the surgical option because for many, this can be the best treatment and has very little risk involved. The risk reward ratio for this tends to be high. So, for many doctors, it is recommended that surgical treatment should be considered. If you’re not satisfied with the treatments that you’ve been carrying on yourself, you may consider visiting Anderson Podiatry Center for further evaluation of the options that we can offer you.

What to Know About Arthritis Foot Care and What You Can Do

Posted on April 8, 2021June 30, 2025 by admin

Arthritis is a very common problem in the foot and ankle area and can occur in different locations. Because the foot has so many bones, there are many joints that can become painful.

Symptoms

First, it is important to understand what the symptoms of arthritis are. Symptoms tend to present as a deep, dull type of pain that occurs when you first get up in the morning, Then after you take a few steps, it can gradually get better. As the arthritis becomes more severe, it can present all the time, particularly when you’re active. Understand that arthritis occurs when the cartilage that lines the joint becomes worn down and thinner. In severe situations it can wear down to bone. Cartilage is very slick- even slicker than ice! It acts that way to let your joints move more easily.

Causes

There are a multitude of causes that can result in arthritis. It could be from gout attacks, where inflammation in the joints destroys the cartilage, or even rheumatoid arthritis, where patients have autoimmune diseases that can affect the joints.

There may have even been an injury to the joint or bone that caused the cartilage to be damaged. This is especially common in the ankle joint in the case of someone who is a chronic ankle sprainer or has had an ankle fracture. All these conditions can be called “secondary arthritis” as they are related to another issue.

For many that suffer from arthritis, it is commonly referred to as primary arthritis, meaning there is no direct cause. As we age from using our joints, the cartilage tends to wear down

Lastly, the most overlooked cause is foot structure. Very few doctors are trained to evaluate foot structure and foot biomechanics. Some foot types, particularly flat feet, might lend themselves to wearing down joints more than feet that have a normal biomechanical structure.

Where does arthritis occur most commonly?

It occurs most commonly in the great toe joint, ankle and midfoot. In the great toe, it will frequently cause a stiff toe joint, referred to as Hallux Rigidus. It can also occur in the midfoot area, halfway between the toes and the ankle in the arch area. This is also more common as we get older. Finally, it can occur in the ankle joint, especially if you have had multiple ankle sprains, or if you have any kind of history of ankle fracture- this lends itself to a greater possibility of having ankle arthritis at some point in your life.

Five things you can do

Avoid inflammatory foods: Foods high in sugars and carbohydrates should be reduced. Why? Because they create inflammation in your body. Breads, sugar and white flour should be avoided. Also watch out for fructose as this is used in many beverages such as fruit juices and is probably worse than just scarfing down a candy bar. Instead of fruit juice, choose to eat the actual fruit as it’s much healthier for you. This will also help keep your weight down.
Exercise: Yes, that is right, keep moving. Maybe if you used to run and it bothers you too much, consider biking or walking. You may want to take on swimming or other activities. Make sure to modify the frequency and duration because motion helps your body create more growth hormones which can help repair your joints.
Consider supplements: Supplements such as Turmeric, Sam-e , Hyaluronic Acid and Collagen may also be effective and help fight inflammation.
Avoid anti-inflammatories: While they may make you feel good today, the long-term effects are negative for your joint health. An exception to this would be if you have an autoimmune disease such as rheumatoid arthritis that is managed by your doctor.
Use more supportive shoes: If you think you may be an overpronator, meaning you have flat feet, supportive shoes should be considered. You may also want to use an inexpensive over the counter arch supports.

Treatment

Support the foot and ankle: Oftentimes orthotics are recommended as they are custom-made inserts that go in the shoes. They are especially important to help stabilize the bony areas that can lend themselves to arthritis.
Repair and restore the joint: At Anderson Podiatry Center, we do this using stemcell treatment. Regenerative medicine is something we have been using now for over a decade and has been extremely useful for ankle joint problems, great toe joint pain, and pain in the midfoot area and the mid arch. It has proven to show improvement 80-90% of the time.
Block your ability to feel the pain: We do this by shutting off pain signals to the brain. In some cases, especially if the arthritis is in the midfoot or up by the ankle, we can remove one or two branches in the lower leg that block your ability to feel the arthritic pain in your foot or ankle. This is also especially useful and has prevented many patients from going through ankle replacement surgery or ankle fusion surgeries (which have a significant risk factor and recovery time).
Joint surgery: In the worst-case scenarios, when all else fails, there may be a need for revision of a joint by scoping it in the example of an ankle joint. Or finally a joint replacement or fusion.

In summary, if you have these problems, it is important to understand that there’s a lot that you can do to repair your condition. And at Anderson Podiatry Center, we can offer non-surgical approaches and low invasive procedures such as stem cell or nerve resection, which may avoid more major joint replacement surgeries. Do not assume that you have to have an ankle joint replacement or other joints fused to treat your arthritis. Consider the options that you can do first, and if you are still struggling and want to get back to full activity, consider our unique approach.

What Is the Best Treatment for Drop Foot?

Posted on March 16, 2021June 30, 2025 by admin

Drop foot can be a very frustrating problem, and there are many potential causes for it. Before we get into things, it is important to understand what drop foot is. It is the lack of strength to pull your foot or toes upwards, or the ability to move your foot sideways away from your opposite foot. There are approximately five different muscles involved with the weakness that can create drop foot. We won’t be going over these muscle groups in this blog, but it’s important to understand that drop foot can affect both sideways and upwards motion to varying degrees.

When you walk with a drop foot, it may be difficult for your foot to clear the ground. The foot may also want to slap against the ground when your heel hits the floor, or be in such a downward position that you must flex your knee upwards for your foot to clear the ground. This is referred to as a steppage gait and can make walking exceedingly difficult to the point where it has a significant effect on mobility.

What Are the Causes?

Spinal-cord drop foot can be associated with your back, which is referred to as radiculopathy, caused from compression or irritation to the spinal nerves in the lumbar area.
Strokes can be associated with drop foot.
Sciatic nerve trauma, usually caused from hip or knee surgery.
Trauma to the nerves in the leg that stimulate the muscles to contract
Compression of the common peroneal nerve. Compression of this nerve tunnel may be associated with both diabetic and non-diabetic neuropathy. It is often assumed that the drop foot is from a sciatic nerve that was stretched and damaged from hip replacement surgery or knee surgery, because the common peroneal nerve tunnel becomes compressed. Anderson Podiatry Center has successfully reversed drop foot for many patients who were told it was from their back or from damage to the sciatic nerve.

What Is the Common Peroneal Nerve?

The common peroneal nerve is the most overlooked cause of drop foot. It is a branch of the sciatic nerve, and as the sciatic nerve courses down the back of your hamstring area, it divides. One branch goes towards the bottom of the foot, down the back of the calf, and the other branch goes around the outside of your leg, just below the knee.

It’s in this area that the common peroneal nerve tunnel is located. Just beyond the nerve tunnel is the branches that send signals to the leg muscles to contract. When the tunnel is tight, the branches don’t send strong enough signals, and the muscles become weak. This is similar to carpal tunnel syndrome in the hand. This can be the case in diabetes, where there’s compression involved, or non-diabetic neuropathy, because the tunnel can become tight.

At Anderson Podiatry Center, we deal a lot with peripheral nerve disorders and evaluate peripheral nerve issues. Many doctors are not fully trained in the evaluation and treatment of peripheral nerve problems. So, for many of you reading this blog, the potential is that you may have been told there is nothing you can do. You may have had a hip or knee replacement surgery and your sciatic nerve was damaged, which has resulted in drop foot due to the common peroneal nerve.

Treatment

To quickly answer the question as to what the best drop foot treatment is, it’s surgery (especially if the drop foot is significant). If there is high potential that the nerve is compressed, surgery would be the best option because it can give you the most profound improvement.

If there is a delay in surgery, especially after trauma or a surgery that could have caused this, it could lessen the effectiveness of the drop foot surgery. Many say that if you have had a surgery, such as hip replacement, and drop foot occurs, you should wait around six months to a year to see if it improves. However, we strongly disagree with this approach and suggest that if it’s been 2-3 months since surgery, and there is no progression towards improvement, surgery on this nerve tunnel should be performed. Waiting may limit how much improvement the patient gets.

ESTIM: This is a non-surgical treatment that involves multiple visits and electrical stimulation. This is performed with local anesthetic injections, that in combination repair nerve damage and improve circulation to the nerves during treatments.
Tendon transfer surgeries and joint fusions: These surgeries have always been available in conventional surgical training to help stabilize the foot and ankle.
Ankle bracing: there are many types of ankle braces that also may help. In most cases, these are prescribed by the doctor.

In summary, the two most important aspects about drop foot treatment are:

If you’ve had surgery or an injury, and after the first two to three months you’ve not experienced improvement, do not put yourself in a position where you may lessen the effectiveness of the surgery by waiting. With that being said, we’ve also seen patients, years after a surgery caused by drop foot, that still still see improvement on their mobility from drop foot surgery. When surgery is performed, most patients see significant improvement of their lifestyle, even if they have less than 100 percent improvement of their muscle strength.
If you have neuropathy or back problems, don’t assume that you don’t have compression of the common peroneal nerve. It is commonly associated with diabetic and nondiabetic neuropathies.
To conclude, it is not always the case that surgery is the best treatment, but for those whose mobility is significantly impacted, proper assessment of the common peroneal nerve is important. The recovery time and risks are minimal, compared to other surgical options, and if surgery fails, the other options will always be there. When the drop foot is minimal other options such as ESTIM may be considered. So if you or someone you know suffers from drop foot, please consider the common peroneal nerve tunnel as a potential cause.

The Most Common Foot Problem: Plantar Fasciitis

Posted on March 4, 2021 by admin

We are frequently asked, what is the most common foot complaint? Without a doubt, plantar fasciitis is at the top of the list. Oftentimes, it is referred to as heel pain, or heel spur pain. The symptoms of plantar fasciitis often occur first thing in the morning, as the pain exists on the bottom of the heel and is irritated with those initial morning steps. You may hobble to the bathroom, or to go make some coffee, and after a few minutes the pain wears off. However, as it becomes more severe, you may notice the pain throughout the day, and it can come on gradually or all at once.

Plantar fasciitis is seldom caused by trauma. Although it could be caused by you falling on your foot and striking your heel, in most cases, it’s something that just happens and is unpredictable. Foot biomechanics can also play a role.

While plantar fasciitis is a common foot problem, it rarely occurs in your teenage years or early twenties Why is this? One of the ideas is that the fascia loses its elasticity over time. The fascia runs from the ball of the foot to the heel, where it attaches. With every step you take, as the arch flattens, the fascia pulls from its attachment point (aka the heel). When your foot is not bearing weight, the arch is relatively high, but as soon as your bear weight the arch flattens and pulls on the fascia.

This pain from the common foot problem can become very disabling as it can go on for months, or even years in some cases. It is important to note that an x-ray can sometimes show a heel spur, where the fascia attaches to the heel. The old school idea is that this was the source of the pain, however this is seldom the case. If surgery is ever performed to eliminate your plantar fasciitis (using small incisions to partially release the fascia), nothing is done to the spur. Patients have a remarkably high success rate with this form of surgery, proving that it is not the spur. In fact, the spur could have been created by the fascia pulling from your heel.

What Can You Do For Plantar Fasciitis?

Since plantar fasciitis is one of the most common foot problems, it is also the one that has the most treatment options. It can get confusing because everyone, including your shoe salesman, will claim to have the solution.

But the actual treatment solutions for plantar fasciitis are limited. There are many options that can help a bit, as these are referred to as “band-aid approaches”. These band-aid approaches include anti-inflammatories, icing, and stretching. They are fine to try, and in some cases can help a lot, but it’s important to do these at the earliest stages of your heel pain.

You can also try using supports, and if the shoes you wear for walking, hiking or running are worn down, consider replacing them. If these attempts fail, or if you find yourself having to go back to these approaches time and time again, it may be time to seek professional help.

Orthotics

Orthotics are one of the foundational things that a podiatrist will use. Orthotics help hold and support the foot better so that the fascia does not want to pull away from the heel. It is important that the orthotics being made utilizes either a casting technique, or a digital system by taking a non-weight bearing, impression of your foot. This captures the foot in its ideal functional position in order to get more precise control of your foot. Orthotics minimize how much that fascia is pulling from your heel by supporting your bony structure better.

Stem Cell Treatment

Podiatrists traditionally used cortisone injections to treat plantar fasciitis, but at Anderson Podiatry Center, we still do this on occasion, but recommended the consideration of stem cell treatment. It’s been known from recent studies that the fascia is not truly inflamed, but rather it’s tissue is breaking down and in need of repair. So what better way to do this than with stem cells (we typically use placenta cells).

Shockwave Treatment and Laser

Shockwave sends powerful sound waves into the heel area. This traumatizes the heel, but puts your body into a repairative mode that helps repair the fascia. We also use a treatment called MLS laser which helps by improving the functionality of the mitochondria in your cells to repair the fascia.

Surgery

Surgery is done on occasion, but only after conservative measures have failed. It’s typically done with a scope, and we make a small incision on both sides of the heel. Patients can ambulate immediately, but usually have to wear a movable cast for approximately two-four weeks. Success rate for this is quite high.

If your attempts to remedy your heel pain are not working, it may be time to move on to a more aggressive treatment plan. The longer you wait to see a podiatrist, the more time and treatment options you may need to eliminate the pain.

Three Ways Peripheral Neuropathy Can Affect Your Walking

Posted on February 17, 2021June 30, 2025 by admin

For many, neuropathy becomes a common and difficult part of their life. It’s been estimated that 25-30% of people in the U.S will experience neuropathy at some point in their life. Peripheral neuropathy refers to the nervous system outside of the spinal cord and brain area. It is the nerves that go down into the foot & leg, or into the arms & hands. The symptoms of Peripheral neuropathy can include burning, tingling, numbness, and oftentimes weakness. It usually affects both feet, but not always – which is why peripheral neuropathy can affect walking. There are many nerve fibers directly underneath the skin called sensory nerves, and when these nerves start to die away it inhibits you from feeling pressure, resulting in not being able to feel your feet on the ground. People may also not be able to feel hot and cold on their feet.

Dibaetic Neuropathy

Diabetic neuropathy affects approximately 50-70% of those with diabetes, and when severe can result in ulcers and even amputation.It could start with something as simple as a callous that the patient cannot feel. This then creates an ulcer which can become infected. Oftentimes because there is a lack of feeling, the patient has no pain, and therefore no warning signs. If this results in an amputation, the situation can become life threatening. If you do not have diabetes, it is important to know that many people may be prediabetic, and the first signs can be symptoms of neuropathy in the feet. So if you have never been diagnosed with diabetes, but you’re getting neuropathy symptoms, there’s a chance that you could be pre-diabetic.

There are other types of neuropathy including chemotherapy induced neuropathy and alcoholic neuropathy. Aside from diabetic neuropathy, the most common diagnosis patients are given is idiopathic neuropathy – meaning neuropathy from an unknown cause.

What Are The Benefits Of Walking?

The benefits of walking are both mental and physical. Mentally, exercise has been shown to help people emotionally. Exercise can help increase dopamine levels in the brain (dopamine is a neurotransmitter in the brain that is associated with the feel good sensation you have after exercise).It is also thought that exercise can help you sleep better. The importance of sleep has become more apparent as it not only helps you feel better the next day, but can also help with high blood pressure, cancer and diabetes. Walking may also help to keep your weight down, which can have a big impact on controlling your blood sugar levels, blood pressure and even joint arthritis.

So how does peripheral neuropathy affect your walking? To better understand, I’d like to clarify the three ways neuropathy can have an effect on walking.

Number 1 – PAIN

If you are in a lot of pain from the burning and tingling in your feet, maybe you’ll feel uncomfortable to go on a walk. If the pain is mild, you can still go for a walk, but maybe just not as far as you could before. So if your symptoms are not that painful, that’s even more of a reason to consider walking.

If your pain is manageable while you walk, it’s a good idea to gradually increase the frequency and duration each time you walk. One principle to remember is that your body needs rest days. So rather than walking every day for 25 minutes five or six days per week, it may be better to walk four days for 35-45 minutes. Why? It’s thought that those extra minutes (for example, 35 minutes) tend to rev up your metabolism more for a longer period after the aerobic activity. This leads to more calories burned and better cardiac health. If walking is too painful, consider biking, swimming or pool exercises instead.

Number 2 – NUMBNESS

If your nerves are significantly damaged, you may experience numbness in your feet. This also serves as another factor that suppresses your desire to walk. Why? Because your ability to feel your feet on the ground has been reduced.

When your ability to feel your feet on the ground diminishes, you could feel unstable and possibly walk with a wider gait. In some cases you may even shuffle due to the lack of feeling. This can be a challenge, and it might make you even more susceptible to falling. For this scenario it is best to walk on flat surfaces and avoid walking or hiking on irregular terrain.

Number 3 – WEAKNESS

Another symptom caused by peripheral neuropathy is weakness. This ranges from mild to severe in the case of drop foot, which is when it’s difficult to pull your foot or toes upwards. You could also be experiencing what I call “weakfoot”, meaning it’s difficult to push your foot off the ground. Again, it is most important to avoid irregular terrain, so it is important to consider or experiment with other forms of exercise.

If you have weakness or numbness that is not too severe, and you’re able to walk for exercise, then make sure your shoe selection is good. Generally, a shoe with more support (which is called a motion control shoe) should be used. Additionally, keep an eye on your shoes and make sure you do not overwear them to the point that they start to break down.

These are the ways that neuropathy can affect your walking. Please understand that it is important to seek treatment if you’re experiencing neuropathy. Contrary to what conventional medicine says, you do not have to live with it or take medications. At Anderson Center for Neuropathy and Chronic Pain, we can reverse the symptoms of neuropathies with surgical or non-surgical means.

Walking is one of the best forms of exercise for your mental and physical well-being. We hope this blog gives you a better understanding of peripheral neuropathy affect walking and how it impacts exercise regimen.

Treatment for neuropathy in legs and feet Broomfield and Fort Collins. Call or email us today.

Exercises to Improve Walking for People 50+ with Peripheral Neuropathy

Peripheral neuropathy can make walking more challenging due to loss of sensation, muscle weakness, and balance issues. However, staying active with gentle, low-impact exercises can improve mobility, reduce discomfort, and enhance overall stability.

Safety Tips Before You Start

Choose a stable surface – Perform exercises near a chair, wall, or countertop for support.
Wear proper footwear – Supportive, non-slip shoes reduce the risk of falls.
Go slow and listen to your body – If you feel pain, dizziness, or weakness, stop and rest.
Exercise at the right time – If neuropathy worsens at certain times of the day (e.g., after long periods of standing), adjust your routine accordingly.
Stay hydrated and take breaks – Dehydration and fatigue can increase fall risks.

1. Gentle Stretching for Flexibility

As we age, muscles naturally become tighter, increasing the risk of falls. Stretching helps keep the legs flexible and reduces stiffness.

Seated Calf Stretch (Safer Alternative)

Sit in a sturdy chair, extend one leg, and gently pull your toes toward you using a towel or band.
Hold for 20-30 seconds per leg.

Ankle Circles (Improves foot mobility)

While seated, lift one foot and slowly rotate your ankle in circles to increase flexibility.
Do 5-10 circles in each direction.

2. Low-Impact Aerobic Exercise for Better Circulation

Aerobic activities increase blood flow and nerve function, helping slow neuropathy progression. Safe options for older adults include:

Seated Marching – Sit tall in a chair, lift one knee at a time in a marching motion. (Great alternative to walking!)
Slow, short walks indoors – Use a walker or cane for added support if needed.
Water aerobics or pool walking – The water provides natural support, reducing strain on joints.
Stationary cycling (with back support) – Helps strengthen legs without impact on the feet.

3. Calf Raises for Strength and Stability

Weak calf muscles can make it harder to lift the heels and maintain balance while walking.

How to do it: Stand near a chair or counter for support. Slowly rise onto your toes, hold for a few seconds, and lower back down.
Modifications: If standing is difficult, try a seated version by pressing the toes down while lifting the heels off the floor.
Reps: Aim for 10-15 repetitions for 2-3 sets.

4. Leg Raises to Prevent Falls

As neuropathy weakens the hips and legs, walking can feel unsteady. Strengthening these muscles can improve control and confidence.

Seated Leg Raises (Easiest Version) – Sit in a sturdy chair, straighten one leg, hold for 5-10 seconds, then switch sides.
Standing Side Leg Raises – Holding onto a chair, lift one leg to the side, keeping your torso straight. Lower slowly and repeat 10 times per leg.
Modification: If standing is too difficult, try side leg lifts while seated.

Final Tips for Success

Start with shorter sessions (5-10 minutes) and increase gradually.
Focus on posture – Keep your chest lifted and shoulders relaxed while exercising.
Consider a balance aid – If you feel unsteady, use a cane or walker when doing standing exercises.
Try chair exercises – If standing is difficult, most exercises can be done while seated for safety.

By practicing these exercises regularly, adults 50+ can improve strength, reduce fall risks, and regain confidence in walking despite peripheral neuropathy.

Frequently Asked Questions

What exactly is peripheral neuropathy, and how does it impact mobility?

Peripheral neuropathy involves damage to the nerves outside the brain and spinal cord, often leading to sensations like burning, tingling, numbness, and weakness in the feet and legs. This nerve damage can hinder your ability to sense the ground, making walking challenging and increasing the risk of instability and falls.

How prevalent is diabetic neuropathy, and what are the potential dangers?

Diabetic neuropathy affects 50-70% of individuals with diabetes, potentially leading to severe complications such as ulcers and amputations. Symptoms often start with numbness, which can mask injuries, allowing them to become serious. Even without a diabetes diagnosis, neuropathy symptoms may indicate pre-diabetes, necessitating early intervention.

What advantages does walking offer for those with neuropathy?

Walking provides numerous benefits, including improved mood, better sleep quality, weight management, and enhanced heart health. It helps regulate blood sugar levels and can reduce the risk of complications like high blood pressure and joint issues. Walking can be a safe and effective exercise with proper precautions.

How can pain from peripheral neuropathy affect walking?

Pain from neuropathy can deter walking, but managing the pain and gradually increasing walking duration can be beneficial. When walking becomes too painful, alternatives such as cycling, swimming, or water aerobics can provide similar health benefits without exacerbating the pain.

What steps should be taken if neuropathy causes numbness or weakness?

Numbness and weakness can compromise balance and safety. It is crucial to walk on smooth, even surfaces and wear supportive shoes to prevent falls. For severe symptoms, consider low-impact activities like swimming or stationary biking to maintain fitness without risking injury. Regular monitoring and appropriate footwear are key to managing these challenges.

Ingrown Toenails: Treatments and Five Things You Can Do

Posted on January 27, 2021July 1, 2025 by admin

Ingrown toenails can be one of the most painful foot conditions one can experience. But did you know that ingrown toenails can sometimes be treated with home remedies? Here, we’ll discuss what you should do and when it is appropriate to seek professional attention for ingrown toenail treatment.

What exactly is an ingrown toenail?

As the name implies, you would assume the nail is cutting into your flesh and getting buried into the skin. However, this is not the case. It simply means the hard nail is being an irritant to the skin next to it and in some cases, it can actually cause a breakdown in your skin. If the toenail is not clean, it is likely that bacteria will get into the skin where the breakdown occurs.

What causes an ingrown toenail?

Tight fitting shoes could start the problem, so make sure you do not wear shoes that are too narrow or too short. Proper sizing is important.

Trauma – If you drop something heavy like a frozen turkey on your toenail it may cause it to injure the flesh around it, thus causing the nail to dig in. You could also lose the nail in which case it may grow back deformed and then grow in.

Congenital nails – Ingrown nails may be caused by genetics factors than most would expect. It is not uncommon to hear patients say they are getting an ingrown nail just like their dad did when he was their age.

Improper trimming – It’s important to be careful when trimming your nails. It is true that you should trim your nails straight across. However, you must be careful not to leave a sharp corner on the nail; it is okay to round that corner slightly in some cases. Also, trimming your nails too short should be avoided.

Fungus – A fungal infection of the nail can deform it. The nail can become more curved and grow in on the side. Or it may be thickened, and this can also cause more pressure in the middle or sides of the nail.

Foot deformities – If you have toes that deviate, such as a hammertoe or a bunion, the nail may grow in as a result of this. The big toe rubbing against the second toe in the case of a bunion, is a great example.

What should you do if you have an ingrown nail?

Early treatment is important. At first, if the pain is minimal with little to no redness along the side of the nail, you should start treatment. Here are some things you can do to control it:

Soak your foot in soapy water three to four times a day for 10-20 minutes. Dry your foot well and apply an antibiotic cream such as Neosporin.

Get out of your closed shoe as much as possible if it is possible.

Try to gently massage the skin, always from the nail edge. Using coconut oil would be ideal when you do this.

If it is just the tip of the nail edge digging in, you might be able to lift the nail up and use dental floss. It is important to consider using waxed floss.

When to seek medical attention?

If you made the attempts I have suggested, and the pain persists, then it is time to get a professional opinion on your ingrown toenail treatment. Also, there is no deadline as to when you can see the doctor. If your toe is very painful; either red, hot or draining pus, you must make sure you call your podiatrist. No amount of the home care I have suggested may help in this situation.

If you are a diabetic or have problems with poor circulation or have a medical condition that has negative effects on your nervous system, you must immediately see a doctor.

What will the doctor do at the office visit?

In a situation where the edge of the nail is digging, the nail edge may need to be removed. A portion of the nail border or borders may need to be removed. When the edge is removed, in most cases, a chemical is applied that kills the cells that form the nail. No sutures and incisions are used, and most patients do not take medication for pain. In most cases, the patient may go back to work the next day and can work full time.

There is a possibility of a fungal nail. If the nail is not infected and not as severe in many cases, treating the fungus may restore more normal nail growth and therefore reduce the thickness and nail deformity. There are several treatment options the doctor may speak to you about. This includes the use of topicals, oral medication or laser nail treatment. Of these three, laser nail treatment is the most successful. Be aware that not all podiatrists offer to do a laser treatment. So you may consider that when getting a professional opinion of your ingrown nail, especially if you have yellow,thickened and deformed nails.

Now that you know all about ingrown toenail treatment, you will have a more informed plan of action if this happens to you.